Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “open resource”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 127 records · Page 7Linked to original sources
PubMed2005

Cost-effectiveness of formoterol and salbutamol as asthma reliever medication in Sweden and in Spain.

This study aimed to evaluate the cost-effectiveness of formoterol (Oxis) Turbuhaler 4.5 microg and salbutamol 200 microg as reliever medications in Sweden and Spain. The study used data on effectiveness (exacerbations and symptom-free days) and resource utilisation from an open, 6-month, parallel-group, multicentre randomised trial with 18,124 asthma patients in 24 countries. Country-specific unit costs for Sweden and for Spain were used to transform resource utilisation data into costs. Total healthcare costs were not significantly different between formoterol and salbutamol dry powder inhalers in Sweden, whereas in Spain, the healthcare costs were 20% higher for formoterol vs. salbutamol pressurised metered dose inhalers. Total healthcare costs increased with disease severity, defined according to the Global Initiative for Asthma guidelines. Compared with salbutamol, formoterol produced statistically significant improvements in effectiveness, less reliever and maintenance medication usage, reduced healthcare resource utilisation, with no increase or a limited increase in healthcare cost.

Administration, Inhalation↗
PubMed2005

The European panel on the appropriateness of gastrointestinal endoscopy guidelines colonoscopy in an open-access endoscopy unit: a prospective study.

BACKGROUND: The demand for gastrointestinal endoscopy is increasing in most developed countries, resulting in an important rise in overall costs and waiting lists for endoscopic procedures. Therefore, adherence to appropriate indications for these procedures is essential for the rational use of finite resources in an open-access system. AIM: To assess indications and appropriateness of colonoscopy according to the European Panel on the Appropriateness of Gastrointestinal Endoscopy (EPAGE) criteria. METHODS: From May to June 2004, all consecutive patients referred to our Unit for open-access colonoscopy were considered for inclusion in this prospective study. Appropriateness of each colonoscopy was established according to the EPAGE criteria. In order to evaluate whether appropriateness of use correlated with the diagnostic yield of colonoscopy, relevant endoscopic findings were also recorded. RESULTS: A total of 350 consecutive patients were included in the study. In 38 of them, the colonoscopy indication was not listed in the EPAGE guidelines and, consequently, they were not evaluated. In the remaining 312 patients, the indication for the procedure was considered inappropriate in 73 (23%) patients. Both referring doctor characteristics (specialty and health care setting) and patient data (age) correlated with appropriateness of endoscopy. The diagnostic yield was significantly higher for appropriate colonoscopies (42%) than in those judged inappropriate (21%) (P = 0.001). CONCLUSIONS: A noteworthy proportion of patients referred for colonoscopy to an open-access endoscopy unit are considered inappropriate because of their indication, with significant differences among specialties. These results suggest that implementation of validated guidelines for its appropriate use could improve this situation and, considering the correlation between appropriateness and diagnostic yield, even contribute to improve the prognosis of patients with colorectal diseases.

Adult↗
PubMed2005

Large-scale general collection of wild-plant DNA in Mustang, Nepal.

The deposit of DNA samples of wild plants that correspond to voucher specimens is highly informative and greatly enhances the value of the herbarium specimens. The Society of Himalayan Botany (SHB), Tokyo, has assembled general collections of flowering plants of the Sino-Himalayan region for more than 40 years. In a trial of the collection of these types of bioresources for use in basic research, we adopted FTA cards, which have recently been used for large-scale collection of DNA of humans, microorganisms and viruses, for the general collection of DNA samples of wild plants during a botanical expedition in Mustang, Nepal, in 2003. Three hundred and fifty-five plant specimens from Mustang, Nepal, were collected along with the corresponding DNA samples. Examination of the quality of the DNA samples by PCR demonstrated the utility of the collection system. The identification of all of the specimens collected, as well as data from the specimens, will be presented on the Flora of Nepal Database website (http://ti.um.u-tokyo.ac.jp/default.htm), which is open to the public. The DNA resources will be identified on the website and distributed openly by the SHB to researchers worldwide for basic research.

Botany↗
PubMed2004

ORFDB: an information resource linking scientific content to a high-quality Open Reading Frame (ORF) collection.

The ORFDB (http://orf.invitrogen.com/) represents an ongoing effort at Invitrogen Corporation to integrate relevant scientific data with an evolving collection of human and mouse Open Reading Frame (ORF) clones (Ultimate ORF Clones). The ORFDB serves as a central data warehouse enabling researchers to search the ORF collection through its web portal ORFBrowser, allowing researchers to find the Ultimate ORF clones by blast, keyword, GenBank accession, gene symbol, clone ID, Unigene ID, LocusLink ID or through functional relationships by browsing the collection via the Gene Ontology (GO) Browser. As of October 2003, the ORFDB contains 6200 human and 2870 mouse Ultimate ORF clones. All Ultimate ORF clones have been fully sequenced with high quality, and are matched to public reference protein sequences. In addition, the cloned ORFs have been extensively annotated across six categories: Gene, ORF, Clone Format, Protein, SNP and Genomic links, with the information assembled in a format termed the ORFCard. The ORFCard represents an information repository that documents the sequence quality, alignment with respect to public protein sequences, and the latest publicly available information associated with each human and mouse gene represented in the collection.

Animals↗
PubMed2005

Internet offenders: traders, travelers, and combination trader-travelers.

The Internet opens a vast array of communication, entertainment, and educational resources for children; however, it also opens a gateway to home and school for offenders who wish to exploit children. A convenience sample of 225 cases published in the news media was examined. The cases were classified using law enforcement terminology to describe Internet offenders as traders, travelers, or combination trader-travelers. The media is seen as a critical source of information for the public to be aware of how the Internet is being used to commit sexual exploitation and sex crimes against children.

Adolescent↗
PubMed2001

Feasibility of day-care open cholecystectomy: evaluation in an inpatient model.

BACKGROUND: Open cholecystectomy is still a fairly frequently performed operation worldwide, and is used where laparoscopic surgery has failed or is contraindicated, and where some surgeons do not operate laparoscopically for technical reasons. In developing countries laparoscopic cholecystectomy is costly and is available only in a few centres. The present study was conducted to assess the feasibility of day-care open cholecystectomy using an inpatient model. METHODS: Thirty patients were subjected to open cholecystectomy. Intraoperative nasogastric decompression and local wound infiltration with 0.25% bupivacaine was carried out. Postoperatively patients were encouraged to be ambulant, pass urine and start oral fluids. Intravenous fluids and parenteral medication were stopped at 8 p.m. when patients were assessed for feasibility for discharge. All patients were reassessed the next morning for any adverse effects that could have occurred had the patients been discharged on the evening of surgery. RESULTS: Prospectively, 73.3% of patients were considered to be dischargeable on the evening of surgery; but on reassessment the next morning, retrospectively, 93.3% of patients were actually dischargeable on the evening of surgery. A total of 76.6% of patients was actually discharged within 24 h of surgery. No patient required readmission. On follow up there were no complications that could be attributable to early discharge. A total of 83.3% of patients approved of day-care open cholecystectomy. CONCLUSIONS: Day-care open cholecystectomy is safe and feasible. In developing countries, where the use of laparoscopic surgery is limited due to resource constraints, day-care open cholecystectomy can lead to substantial savings in health-care resources.

Adult↗
PubMed2006

Resource utilization in a Canadian national study of people with schizophrenia and related psychotic disorders.

OBJECTIVE: To determine how the use of the newer, so called atypical antipsychotic medications, effects the pharmacoeconomic treatment burden of schizophrenia and related conditions and to provide a clear comparison of the costs and risks associated with these atypical drugs. METHOD: In this 2-year, open-label, prospective study, resource utilization (RU) data were collected on 160 patients with these conditions. A comparison between risks and costs was performed by combining the generalized CNOMSS data on both economic factors and risk assessments. RESULTS: The main findings of the study were that the total adjusted 1- and 2-year costs were lowest for quetiapine. Drug acquisition costs were lowest for risperidone for both the 1- and 2-year cohorts. Clozapine use was predictably associated with the highest overall and medication costs at both 1 and 2 years. CONCLUSION: Treatment with risperidone or quetiapine was associated with the lowest overall costs when compared with olanzapine or clozapine.

Adult↗
PubMed2004

Restrictions impeding web-based courses: a survey of publishers' variation in authorising access to high quality on-line literature.

BACKGROUND: Web-based delivery of educational programmes is becoming increasingly popular and is expected to expand, especially in medicine. The successful implementation of these programmes is reliant on their ability to provide access to web based materials, including high quality published work. Publishers' responses to requests to access health literature in the context of developing an electronic Master's degree course are described. METHODS: Two different permission requests were submitted to publishers. The first was to store an electronic version of a journal article, to which we subscribe, on a secure password protected server. The second was to reproduce extracts of published material on password protected web pages and CD Rom. RESULTS: Eight of 16 publishers were willing to grant permission to store electronic versions of articles without levying charges additional to the subscription. Twenty of 35 publishers gave permission to reproduce extracts of published work at no fee. Publishers' responses were highly variable to the requests for access to published material. This may be influenced by vague terminology within the 'fair dealing' provision in the copyright legislation, which seems to leave it open to individual interpretation. Considerable resource costs were incurred by the exercise. Time expended included those incurred by us: research to identify informed representatives within the publishing organisation, request 'chase-ups' and alternative examples being sought if publishers were uncooperative; and the publisher when dealing with numerous permission requests. Financial costs were also incurred by both parties through additional staffing and paperwork generated by the permission process, the latter including those purely borne by educators due to the necessary provision of photocopy 'course packs' when no suitably alternative material could be found if publishers were uncooperative. Finally we discuss the resultant bias in material towards readily available electronic resources as a result of publisher's uncooperative stance and encourage initiatives that aim to improve open electronic access. CONCLUSIONS: The permission request process has been expensive and has resulted in reduced access for students to the relevant literature. Variations in the responses from publishers suggest that for educational purposes common policies could be agreed and unnecessary restrictions removed in the future.

CD-ROM↗
PubMed2004

Water development strategy as a driving force for sustained rangeland management by local communities in sub-Saharan Africa.

Water is the major food component for the maintenance of animals. Although Africa is endowed with diverse agricultural environments, the survival of animals in Sahelian and sub-Sahelian Africa is threatened by the lack of water. Animals need water as an essential nutrient, a component of the body, and for conductive or evaporative cooling. Water needs are met mainly through drinking free water and to a lesser extent by utilising water that forms part of the feed. However during the long dry season, surface water resources dwindle and the water content of available forage decreases, thereby increasing the animals' demand for water. Consequently animals have to walk for long distances to obtain adequate forage and water, which in turn raises the demand for these resources. Water can be used to direct and regulate rangeland management in this open access environment, to maintain range resources and to improve their quality. Water development, which takes into consideration usable forage, despite some intra- or inter-annual variability, plays an important role and its spatial distribution will affect the grazing intensity of forage resources. Sound water development and management strategies integrating local communities in the decision-making will set up a firm basis for sustained range management in the free and open access environment of sub-Saharan Africa where lack of financial input, social and cultural habits and above all the environmental condition do not permit large scale fencing as in other parts of the world.

Africa South of the Sahara↗
PubMed1997

Medical necessity and defined coverage benefits in the Oregon Health Plan.

The policy debate in Oregon has primarily focused on the Prioritized List of Services. However, little information is available on how defined coverage benefits and managed care affect the role of medical necessity in determining care for Medicaid patients. This issue is important because medical necessity determinations are currently used by many states to limit extraneous health care costs but require resource-intensive oversight, are open to wide variance, and frequently prompt litigation challenging interpretations of what is necessary and what is not. The qualitative study described here addressed whether medical necessity remains a salient and useful concept in the Oregon Health Plan. Our results indicate that defined coverage benefits, as described by the funded portion of the Prioritized List of Services, supplant medical necessity determinations for coverage, while managed care incentives limit the need for medical necessity determinations at the provider level. Clinical choices are, for the most part, guided by providers' judgment within the financial constraints of capitation and by targeted use management techniques. The combination of capitated care and Oregon's defined coverage benefits package has marginalized the use of medical necessity, albeit with consequences for state oversight of Medicaid services.

Government Regulation↗
PubMed2006

The value of the dedicated orthopaedic trauma operating room.

BACKGROUND: Trauma centers and orthopaedic surgeons have traditionally been faced with limited operating room (OR) availability for fracture surgery. Orthopaedic trauma cases are often waitlisted and done late at night. We investigated the feasibility of having an unbooked orthopaedic trauma OR to reduce nighttime cases and improve OR flow. METHODS: A retrospective analysis was performed for two 1 year time periods before and after the introduction of an unbooked trauma OR. The unbooked trauma OR is kept open for urgent and semi-urgent cases from 7:45 am to 5 pm 6 days per week, and is under the control of Orthopaedics; no elective cases are scheduled in the unbooked trauma room. We collected OR time data on two common surgical cases (dynamic hip screw and closed femoral nailing) done before and after introduction of the unbooked orthopaedic trauma OR. We also reviewed data on waitlist cases, surgical time, anesthetic times, OR utilization, and surgical complications before and after the introduction of the unbooked trauma room. RESULTS: The availability of the unbooked trauma OR significantly improved operating suite flow. The proportion of hip fractures done after 5 pm was reduced by 72% (p<0.01). The number of all orthopaedic waitlist cases started after 5 pm was reduced by 6% (p<0.021). The distinct shift toward performing add-on cases during daytime hours resulted in a 6% reduction in OR over-utilization. Closed femoral nailing done at night required significantly more OR time (261 minutes versus 219 minutes, p<0.04). Hip fracture surgeries and femoral nailings done at night were noted to have a higher incidence of surgical complications (p<0.04 and p<0.036). CONCLUSION: The availability of an unbooked orthopaedic trauma room resulted in a measurable shift from performing "add-on" cases to daytime surgery and may reduce complications. We recommend that hospitals and orthopaedic trauma services commit resources toward having an open OR reserved for orthopaedic trauma.

Appointments and Schedules↗
PubMed1997

QALYs and mental health care.

Quality-adjusted life year measures (QALYs) have been fervently debated by researchers and decision makers concerned with resource allocation in the health care sector. They have been heralded as important aids to planning and priority setting, but also criticised on technical and ethical grounds. This paper examines these arguments with special reference to mental health care, the intention being to highlight the strengths and shortcomings of QALYs in this context. Issues pertinent to the application of QALYs in health care evaluation more generally are also reviewed. Whilst the rationale and underlying principles of the utility measurement approach are sound, the generic QALY as it is currently constructed represents an insensitive measure of the outcomes of mental health care. In the event of an increasingly QALY-driven priority-setting environment, however, abandonment of QALYs runs the risk of inappropriately marginalising people with mental illnesses in the resource allocation process. This opens up the possibility of developing a mental-health specific measure of utility that, in combination with cost data, would provide useful and appropriate summary information across treatments and programmes of mental health care.

Cost-Benefit Analysis↗
PubMed1998

[Constant social and spatial environment in aging: memory theory, case examples, practice relevance].

An ecological theory of remembering is formulated which is based on the patterns of meaningfulness in the social and spatial environment. The specific ecological relationship to the environment is affinitive, and also opens access to the resources of the past. In the present study, conditions for this access (in particular with older people) were investigated. It is assumed that older people, especially, when they lose someone with whom they had a fixed relationship seek counselling and that abrupt changes in the spatial environment, such as moving to a home, are rejected by older people. These hypotheses were checked on the basis of material (N = 120) gathered in a counselling service for the aged and they were essentially confirmed. To make matters clear, "typical" and thus every-day experiences of maintenance and loss of competence are cited from the material. Finally, practical conclusions are drawn with regard to work with the aged.

Activities of Daily Living↗
PubMed2005

Prospects for glycoinformatics.

High-throughput and automated techniques (mass spectrometry in particular) allow increasingly rapid structural analysis of complex glycans. Information concerning the primary structure (composition, sequence and linkages), three-dimensional structure (including dynamics) and interactions of glycans is now available in sufficient quantity to justify the maintenance of databases and search facilities. Several such resources (both commercial and open access) are now available as web tools. To derive the full value of glycan databases, it will be necessary to develop a universally accepted machine-readable structural representation of glycans.

Animals↗
PubMed2003

Medication errors in the emergency department: a systems approach to minimizing risk.

Adverse drug events caused by medication errors represent a common cause of patient injury in the practice of medicine. Many medication errors are preventable and hence particularly tragic when they occur, often with serious consequences. The enormous increase in the number of available drugs on the market makes it all but impossible for physicians, nurses, and pharmacists to possess the knowledge base necessary for fail-safe medication practice. Indeed, the greatest single systemic factor associated with medication errors is a deficiency in the knowledge requisite to the safe use of drugs. It is vital that physicians, nurses, and pharmacists have at their immediate disposal up-to-date drug references. Patients presenting for care in EDs are usually unfamiliar to their EPs and nurses, and the unique patient factors affecting medication response and toxicity are obscured. An appropriate history, physical examination, and diagnostic workup will assist EPs, nurses, and pharmacists in selecting the safest and most optimum therapeutic regimen for each patient. EDs deliver care "24/7" and are open when valuable information resources, such as hospital pharmacists and previously treating physicians, may not be available for consultation. A systems approach to the complex problem of medication errors will help emergency clinicians eliminate preventable adverse drug events and achieve a goal of a zero-defects system, in which medication errors are a thing of the past. New developments in information technology and the advent of electronic medical records with computerized physician order entry, ward-based clinical pharmacists, and standardized bar codes promise substantial reductions in the incidence of medication errors and adverse drug events. ED patients expect and deserve nothing less than the safest possible emergency medicine service.

Adult↗
PubMed2002

The role of multilateral institutions.

In line with its mission of alleviating poverty through support for environmentally and socially sustainable economic development, The World Bank (along with some other multilateral development banks) is working to help developing countries capture a share of the emerging global market in greenhouse-gas-emissions reductions ('carbon trading'). Under the Kyoto Protocol of the United Nations Framework Convention on Climate Change (UNFCCC), the Joint Implementation instrument and the Clean Development Mechanism now provide an opening for substantial international resource transfers and potential for supporting sustainable development through the transfer of cleaner technologies or sustainable forestry and agro-forestry practices. For example, carbon sequestration represents a non-extractive non-consumptive sustainable use of living natural resources that can be incorporated within a multiple-use 'integrated ecosystem management' approach. The World Bank initiated the Prototype Carbon Fund (PCF) in April 2000, to help spur the development of a global carbon market and to 'learn by doing' how to use carbon-purchase transactions across a range of energy-sector technologies (and some forestry applications) to achieve environmentally credible and cost-effective emissions reductions that benefit developing countries and economies in transition. Building on the success of the PCF ($145 million raised from public and private-sector investors), The World Bank expects to launch two new funds in 2002: the Biocarbon Fund and the Community Development Carbon Fund. These funds will target synergies between carbon markets and objectives such as biodiversity conservation, combating desertification and small-scale community-driven development. Experience from the PCF shows that developing countries can have a comparative advantage in supplying this global market, as emissions reductions can be achieved in developing countries in the range of $3-$5 per ton of CO(2) equivalent, compared with a marginal abatement cost of $10-$15 per ton of CO(2) equivalent in most countries within the Organization for Economic Cooperation and Development. However, realizing this economic potential over the next decade, and targeting the market to the rural poor, will require substantial assistance with project development and government legal and institutional capacity building. Specific needs include raising awareness of the potential of carbon markets at all levels (particularly in energy and land-use sectors), clarifying property rights, particularly in the case of communally held land and resources, ensuring the existence of an attractive investment climate, eliminating policies that create perverse incentives and constraints, and mitigating logistical, political and 'reputational' risks that could deter private-sector investors. It will also be necessary to find ways to reconcile the short-term needs of the rural poor and the typically long-term revenue stream associated with carbon sequestration.

Air Pollution↗
PubMed2004

The status, quality, and expansion of the NIH full-length cDNA project: the Mammalian Gene Collection (MGC).

The National Institutes of Health's Mammalian Gene Collection (MGC) project was designed to generate and sequence a publicly accessible cDNA resource containing a complete open reading frame (ORF) for every human and mouse gene. The project initially used a random strategy to select clones from a large number of cDNA libraries from diverse tissues. Candidate clones were chosen based on 5'-EST sequences, and then fully sequenced to high accuracy and analyzed by algorithms developed for this project. Currently, more than 11,000 human and 10,000 mouse genes are represented in MGC by at least one clone with a full ORF. The random selection approach is now reaching a saturation point, and a transition to protocols targeted at the missing transcripts is now required to complete the mouse and human collections. Comparison of the sequence of the MGC clones to reference genome sequences reveals that most cDNA clones are of very high sequence quality, although it is likely that some cDNAs may carry missense variants as a consequence of experimental artifact, such as PCR, cloning, or reverse transcriptase errors. Recently, a rat cDNA component was added to the project, and ongoing frog (Xenopus) and zebrafish (Danio) cDNA projects were expanded to take advantage of the high-throughput MGC pipeline.

Animals↗
PubMed2006

Contribution of host lipids to Toxoplasma pathogenesis.

As an actively dividing organism, the intracellular parasite Toxoplasma gondii must adjust the size and composition of its membranes in order to accommodate changes due to housekeeping activities, to commit division and in fine to produce new viable progenies. Lipid inventory of T. gondii reveals that the biological membranes of this parasite are composed of a complex mixture of neutral and polar lipids. After examination of the origin of T. gondii membrane lipids, three categories of lipids can be described: (i) lipids scavenged by T. gondii from the host cell; (ii) lipids synthesized in large amounts by the parasite, independently from its host cell; and (iii) lipids produced de novo by the parasite, but whose synthesis does not come close to satisfying the entire parasite's needs. These latter must be adeptly acquired from the host environment. To this end, T. gondii diverts a large variety of lipid precursors from host cytoplasm and efficiently manufacture them into complex lipids. This rather remarkable reliance on host lipid resources for parasite survival opens new avenues to restrict parasite growth. Indeed, parasite starvation can be induced upon deprivation from essential host lipids. Lipid analogues with anti-proliferative properties are voraciously taken up by the parasites, which results in parasite membrane defects, and ultimately death.

Animals↗